Case Study 2: Colorectal cancer (CRC) and anaemiaPresenting complaint.Objective dataJill Smith, a 56-year-old lady, has presented to her general practitioner (GP) complaining of lethargy, reduced exercise tolerance, and altered bowel habits. Jill states she has a diet that is high in red meat and processed foods, and drinks approx. 8 standard drinks per week. Jill used to smoke but gave up prior to the birth of her first child 26 years ago. She had blood taken for full blood picture where it was found she was anaemic. Jill has been booked into the day procedure unit (DPU) for a colonoscopy due to her anaemia and family history of colorectal cancer.Vital on admission to DPU BP 164/86 mmhgHR 92 BPMT 37o cRR 21 breaths per minuteWeight 96kgHeight 167cmHypertension diagnosed 3 years agoRheumatoid arthritis (confined to hands) diagnosed 6 years ago. Recently commenced on methotrexate.Father died of bowel cancer 16 years ago aged 71years. Haemoglobin (Hb) Hematocrit (Hct) WBCPlateletsRCCMCVMCH MCHC Serum Iron Ferratin Transferrin85g/L 0.33mL/L6.9 x109/L265 x 109/L 3.0L65 fL25 pg237 g/L7 micromol/L 19 microgram/L 3.1 g/L115 – 165 g/L0.37 – 0.47 mL/L4.5 – 11 x 109/L150 – 450 109/L4.5 – 6.5 1012/L80 – 100fL27 – 32 pg300 – 350 g/L14 – 32 micromol/L 25 – 155 microgram/L 2.0 – 3.6 g/L NUM2409 Adult Health 2 – Assessment 2 Case study Sem 1 2022MedicationsMethotrexate 7.5mg orally once per weekParacetamol and Ibuprofen PRNRamipril 5mg dailyThe following is to be addressed in your presentation. 1. PathophysiologyDiscuss the pathophysiology and diagnosis Colorectal cancer. Include in your answer the pathophysiological changes that may have contributed to Jill’s anaemia.Discuss Jill’s blood results. What other probable causes of anaemia specific to Jill’s comorbidities need to be considered? Support your answer with rationale and references.2. PharmacologyDiscuss the medications Jill is currently prescribed and takes to help manage her Rheumatoid Arthritis symptoms. Include in your answer mechanisms of action, normal dosage, ADR’s and any specific nursing and poly pharmacy considerations (DO NOT USE TABLES).3. Specific Nursing CareDiscuss and provide Evidence Based Research (EBR) and rationale for any pre-procedure preparation Jill may require.Discuss what discharge education would be appropriate post colonoscopy considering Jill’s comorbidities and associated risk factors.The following is to be addressed in your presentation.Specific Assignment instructionsThe aim of this case study presentation is to provide an opportunity for you to apply your new knowledge of specific disease pathophysiology, diagnosis and treatment (pharmacological, non- pharmacological, nursing and allied health professional interventions) to a “real life” clinical scenario. Health Science Science Nursing Share QuestionEmailCopy link Comments (0)
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